Purpose: To investigate the relationship between coronal imbalance and the extent of intervertebral disc degeneration (IVDD) in cases of degenerative scoliosis. Methods: A comprehensive analysis was conducted on 102 patients diagnosed with degenerative scoliosis through a retrospective examination of relevant medical records. The patients were divided into two groups based on whether the scoliosis apex was located at the disc or vertebral body. The scoliosis was classified into three types (Types A, B, and C) according to the Nanjing classification. Coronal and sagittal parameters were measured on the standing radiographs of the whole spine. Hounsfield units (HU) values of the apical disc and the adjacent intervertebral discs (IVDs) of the apical body were obtained from computed tomography scans. The degeneration of the corresponding discs was also graded using the Pfirrmann classification on magnetic resonance imaging. Results: In the patients with the scoliosis apex at the disc or vertebral body level, the HU values of the IVDs were significantly lower in Type B and Type C patients compared to Type A patients. Additionally, the HU values of IVDs showed a negative correlation with coronal balance distance (CBD) and Pfirrmann grades, while CBD showed a positive correlation with Pfirrmann grades. Conclusions: Degenerative scoliosis patients with coronal imbalance exhibit more severe IVDD, which was evaluated using HU values of the IVDs. This suggests that IVDD is closely associated with the presence of coronal imbalance.
Lu et al. (Wed,) studied this question.